CONDUCTION SYSTEM OF HEART

REVIEW OF HEART ;
HEART ;

Heart is a muscular organ that pumps blood throughout the circulatory system. It situated in
between the two lungs in the mediastinum. It is made up of four chambers lungs two atria and two
ventricles. The musculature is more and thick in the ventricle than in the atria. The force of contraction
of the heart depends upon the muscles.

LAYERS OF THE WALL OF HEART ;

1. OUTER PERICARDIUM-
 Outer covering of heart.
 It is made up of two layers which are separated by a space called pericardial cavity.
 Two layers (outer parietal pericardium and visceral pericardium) of pericardium lies in
close approximation separated by a thin film of fluid.
2. MIDDLE MYOCARDIUM-
 Myocardium is the middle layer of the wall of the heart and it is formed by cardiac
muscle fibers or cardiac myocytes.
 Myocardium is responsible for the pumping action of heart.
 Three types of cardiac muscle fibers are present in myocardium ;
a) Muscle fiber which form the contractile unit of the heart
b) Muscle fiber which is pacemaker
c) Muscle fiber which form the conductive system
3. INNER ENDOCARDIUM -
 Endocardium is the inner most layer of the heart wall
 It is a thin, smooth and glistening membrane.
 It is formed by a single layer of endothelial lining the inner surface of the heart.

VALVES OF HEART ;
There are four valve in the heart.
Two valves are in between the atria and the ventricles called atrioventricular valves.
The other two are the semilunar valves, placed at the opening of the blood vessel arisingfrom
the ventricles I, e, systemic arota and pulmonary artery.
ATRIOVENTRICULAR VALVES
SEMILUNAR VALVES
PROPERTIES OF CARDIAC MUSCLES ;
1. EXCITABILITY
2. RHYTHMICITY
3. CONDUCTIVITY
4. CONTRACTILITY

1. EXCITABILITY –
Is define as the ability of a living tissue to give response to a stimulus.
In all tissues the initial response to a stimulus is the development of action potential.
ELECTRICAL POTENTIAL IN CARDIAC MUSCLES;
Action potential
Action potential in a single cardiac muscle fiber occurs in four phases.
1 Initial depolarization
2 Initial repolarization
3 A plateau
4 Final repolarization
ACTION POTENTIAL AND CONTRACTION OF CONTRACTILE FIBERS ;
The action potential initiated by the SA node travels along the conduction system and spread
out to excite the “working ” atrial and ventricles muscle fibers, called contractile fibers.

An action potential occurs in a contractile fibers as follows ;

1. DEPOLARIZATION ;

 Unlike autorhythmic fibers, contractile fibers has a resting membrane potential that is
close -90mV.
 When a contractile fiber is brought to threshold by an action potential from neighboring
fibers, its voltage a gated fast Na+ channel opens.
 These sodium channels are referred to as “fast” because they open very rapidly in
response to a threshold-level depolarization.
 Opening of these channels allows Na+ inflow because the systole of the contractile
fibers is electrically more negative than interstitial fluid and Na+ concentration is higher
in interstitial fluid.
 Inflow of Na+ down the electrochemical gradient produces the rapid depolarization.
 Within a few milliseconds, the fast Na + channels automatically inactive and Na+ inflow
decrease.
2. PLATEAU ;
 The next phase of an action potential in a contractile fiber is the plateau, a period of
maintained depolarization.
 It is due in part to opening of voltage gated slow Ca²+ channel in the sarcolemma.
 When these channel open, calcium channel moves from the interstitial fluid (which have
higher Ca²+ concentration) into the cytosol.
 This inflow of calcium causes even more calcium to pour out of the sarcoplasmic
reticulum into the cytosol through additional calcium channel in the sarcoplasmic
reticulum membrane.
 The increased calcium concentration in the cytosol ultimately trigger the contraction.
Several different type of voltage gated k+ channels are also found in the sarcolemma of
a contractile fibers.
 Just before the plateau phase begins, some of these calcium channels opens, allowing
potassium ions to leave the contractile fibers.
 Therefore, depolarization sustained during the plateau phase because Ca²+ inflow just
balance the K+ outflow.
 The plateau phase lasts for about 0.25sec, and the membrane membrane potential of
contractile fibers is close to 0Mv. By comparison, depolarization in neuron or skeletal
muscle fiber is much briefer, about 1msec (0.001sec), because it lacks of plateau phase.
 3. REPOLARIZATION ;
 The recovery of the resting membrane potential during the repolarization phase of the
repolarization phase of a cardiac action potential resemble that in other excitable cells,
after a delay (which is particularly prolonged in cardiac muscles), additional voltage-
gated K+ channels open.
 Outflow of the K+ restores the negative resting membrane potential (-90mV).
 At the same time, the calcium channels in the sarcolemma and the sarcoplasmic
reticulum are closing, which contribute to repolarization. the resting membrane
potential is about (-90mV).

The mechanism of the contraction is similar in cardiac and skeletal muscle. The electrical activity (action
potential) leads to the mechanism response (contraction) after short delays. As Ca²+ binds to the
regularly protein troponin, which allow the actin and myosin filament to begin sliding past one another,
and tension starts to develop. Substances that alter the movement of Ca²+ channels influence the
strength of heart contractions. Epinephrine, for example, increase the strength of heart contarction
force by enhancing Ca²+ flow into the cystosol.

In muscle, the refractory period is the time interval during which a second contraction cannot be
triggered. The refractory period of the cardiac muscle fiber lasts longer than the contraction itself. As a
result, another contraction cannot begin until relaxation is well underway.

2. RHYTHMICITY –
Rhythmicity is the ability of a tissue to produce its own impulses
regularly. It is more appropriately named as autorythymicity. It is also called self excitation.

AUTORHYTHMIC FIBERS ;
 An inherent and rhythmical electrical activity is the reason for the heart’s lifelong
beats.
 The sources of this electrical activity is a electrical activity is a network of specialized
cardiac muscle fibers called autirhythmic fibers because they are self excitable.
 Autorhythmic fibers because they are self excitable. Autorhythmic fibers repeatedly
generate action potentials that trigger heart contractions. They continue to
stimulate a heart to beat even after it is removed from the body- for example, to be
transplanted into the another person- and all of its nerves have been cut.(NOTE ;
surgeons do not attempt to reattach heart nerves during heart transplant operation.
For this reason, it has been said that heart surgeon are better “plumber ” than they
are “electrician”).
 4. CONDUCTIVITY –
Human heart has a specialized conductive system through which the
impulses from SA node are transmitted to all other parts of the heart.

CARDIAC ACTION POTENTIALS PROPAGATE THROUGH THE CONDUCTION

1. Cardiac excitation normally begin in the sinoartrial (SA) node, located in the right atrial wall just
inferior to the opening of the superior vena cava. SA node cells do not have a stable resting
potential. Rather they repeatedly depolarize to threshold spontaneously. The spontaneous
depolarization is a pacemaker potential. When the pacemaker potential reaches to threshold, it
trigger an action potential. Each action potential from SA node propagate throughout the both
atria via gap junction in the intercalated disc of atrial muscles fibers. Following the action
potential, the atria contacts.
2. By conduction along atrial muscle fibers, the action potential reaches the atrioventricular (AV)
node, located in the septum between the two atria, just anterior to the opening of the coronary
sinus.
3. From the AV node, the action potential enters the aterioventricular (AV) bundle (also known as
bundle of his). This bundle is only the site where action potential can conduct from the atria to
the ventricles.(elsewhere, the fiberous skeleton of the heart electrically insulates the ateria from
the ventricles).
4. After propagating along the AV bundle, the action potential enters both the right and left bundle
branches. the bundle branches extends through the interventricular septum towards the apex of
the heart.
5. Finally, the large-diameter purkinje fibers rapidly conduct the action potential from the apex of
the heart upward to the remainder of the ventricular myocardium. Then, the ventricle contract,
pushing the blood upward toward the semilunar valves.
On their own, auto rhythmic fibers in the SA node would initiate an action potential about every
0.6 second, or 100 times per minute.
This rate is faster than that of any other autorhythmic fibers. Because action potential from the
SA node spread through the conduction system and stimulate other area before the other area
able to generate an action potential at their own, slower rate, the SA node act as the normal
pacemaker of heart.
Nerve impulse from autonomic nervous system (ANS) and blood borne hormone (such as
epinephrine) modify the timing and strength of each heartbeat, but they establish the
fundamental rhythm .
in a person at rest, for eg acetylcholine released by the parasympathetic division of ANS slows
SA node pacing to about 75 action potential per minute or one every o.8 sec.

5. CONTRACTILITY –
Contractility is the ability of tissue to shorten it in length (contraction ) after
receiving stimulus.
REFERENCES